Gender-specific Recovery Support Services: Evolution of the Women s Community Recovery Center to the Women s Recovery Community Center

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1 Gender-specific Recovery Support Services: Evolution of the Women s Community Recovery Center to the Women s Recovery Community Center Introduction Beverly J. Haberle, M.H.S., and William White, M.A. It was not long ago that addiction treatment and recovery was a man s world. The treatment field s organizations were directed and staffed by men, served a primarily male clientele, and utilized theories and techniques drawn exclusively from male experience. Recovery support groups were similarly male-dominated, and women seeking entrance to them faced considerable obstacles to their recovery (White, 1996). That world changed through the efforts of pioneering women whose lives are finally being celebrated (White, 2004). In the intervening years, we have learned as a field that there are important gender differences in almost every important dimension of addiction, treatment, and recovery (Kandall, 1996; Wechsberg, Craddock, & Hubbard, 1998; Walitzer & Dearing, 2006). These new understandings paved the way for genderspecific treatment programs and recovery support groups designed specifically for the needs of addicted women and their families (Schliebner, 1994; LaFave, 1999; Uziel- Miller, & Lyons, 2000; Kaskutas, 1994), and expanded the range of settings in which women with alcohol and other drug problems could be identified and served (Grella & Greenwell, 2004). One limitation of the gender-specific service innovations of recent decades is that they have been developed inside an acute care model of addiction treatment that is illsuited for women with high problem severity and complexity and low recovery assets. As a result, those calling for a shift in addiction treatment from an emergency-room model of brief biopsychosocial stabilization to a model of sustained recovery support are also arguing that this new model must meet the unique recovery support needs of women and people of color (White & Sanders, 2004). This shift to models of sustained recovery management is birthing new and renewed social institutions (e.g., peer-operated recovery support centers, recovery homes) and new and renewed service roles (e.g., recovery coaches, outreach workers). In spite of these advances, we are in the earliest stages of designing institutions and roles to meet the needs of recovering women. The purposes of this article are to briefly describe the emergence of the recovery support center as a new indigenous service institution, profile the history and service components within the Women s Community Recovery Center in New Britain, Pennsylvania, and highlight some of the lessons learned from the Center s first 18 months of operation. Recovery Support Centers 1

2 There are a multitude of needs people experience over the course of their recovery from severe alcohol and other drug problems that are outside the traditional service scope of addiction treatment programs. The growing recognition of the need for non-clinical recovery support services is generating new models for delivering such services. One such model is the recovery support center (RCC). Usually operated by a grassroots recovery advocacy organization (Valentine, White, & Taylor, 2007)(see for a directory of such organizations), the RCC resembles the social fellowship of an AA clubhouse and the service orientation of a social service drop-in center. The Connecticut Community of Addiction Recovery (CCAR) describes its RCC as a: Recovery-oriented sanctuary anchored in the heart of the community. It exists 1) to put a face on addiction recovery, 2) to build recovery capital in individuals, families and communities and 3) to serve as a physical location where CCAR can organize the local recovery community s ability to care. (From Core Elements of A Recovery Community Center, CCAR, 2006) The development of regional RCCs in states like Connecticut and Vermont marks a new approach to the delivery of non-clinical recovery support services. The RCC moves recovery from the church basements to main street, provides a venue for sober socializing, a physical place for recovery development (linkage to recovery-conducive employment, recovery homes, recovery workshops, planned leisure activities, community service work), and serves as a medium for connecting people with recovery needs to people with recovery assets. RCCs also function as an organizational/human bridge between the professional treatment community and the recovery community (White & Kurtz, 2006, p. 32). Because of their service orientation, it would be easy to see the emerging RCCs as simply a new level of care within the existing treatment continuum of care, but RCC leaders reject such a view. They emphasize that what they are providing individuals is not treatment but recovery support services that are designed and delivered, not by clinically trained professionals, but by and for people in recovery. RCC leaders also emphasize that such services are part of their larger goal of developing recovery capital within local communities of recovery and the larger communities in which they are nested an approach that blends individual and family support models with models of community organization and cultural renewal (McCarthy, 2006; Valentine, 2006). History of the Women s Community Recovery Center The Pennsylvania Recovery Organization-Achieving Community Together (PRO- ACT) program was established in 1997 as a grassroots recovery advocacy organization. Its founding goals were to mobilize the members of the recovery community to reduce the stigma of addiction, to educate the public about addiction recovery, and to help shape pro-recovery public policies. In 1998, PRO-ACT received a Recovery Community Support Services Grant from the Center for Substance Abuse Treatment that provided the opportunity to expand PRO-ACT s role within the community and begin to provide peer driven / peer delivered recovery support services throughout Southeastern Pennsylvania. 2

3 Through a highly participatory planning process, PRO-ACT has developed a wide variety of recovery support services designed to help individuals and families initiate and sustain long term recovery and has extended the range of its service focus. While PRO-ACT began in Bucks County, they have expanded their services to include the entire fivecounty Southeast Pennsylvania Region, with special focus on the City of Philadelphia. The latter move has been sparked by a recovery-focused behavioral health care systems transformation process being led by the Philadelphia Department of Behavioral Health (White, in press; see One of the early projects developed by PRO-ACT was Mentor Plus (2000). The Mentor Plus project matched volunteer Mentors with inmates in early recovery ( Mentees ) residing at the Bucks County Correctional Facility (BCCF). The Mentors visit their assigned Mentees once a week during the Mentee s incarceration. The focus of these visits was to develop a recovery plan that would be implemented upon the Mentee s release. As the program evolved, it became clear that female Mentees had a great deal more difficulty transitioning out of the institution and implementing a recovery plan than did their male counterparts. The special needs of female Mentees included safe housing, early financial assistance, recovery-conducive employment, assistance with family problems, support for continued education, and linkage for assistance and support for cooccurring medical and psychiatric illness. At the same time these needs were being identified, another committee within PRO-ACT was exploring the Recovery Centers that were being established in Vermont and Connecticut. Out of that synergy of circumstances, PRO-ACT naively developed the idea of developing a Center that would combine the goals of providing recovery housing for women who needed it and providing a recovery oriented, gender-specific sanctuary for other women in the community within this same facility. By this point, the Council had already had 15 years experience with gender-specific programming, outreach, and support working with women in a recovery community setting. In December of 2004, The Council purchased a building that once served as a women s college dormitory in New Britain, Pennsylvania for use as a Women s Community Recovery Center. The Center was opened to the Community in May of 2005 after months of work establishing a steering committee, fund-raising, attending zoning hearings, hiring staff, recruiting and training volunteers, and developing policies and service procedures. Forty-eight volunteers were recruited and trained as program facilitators and recovery coaches, a 12 session Life Skills program curriculum was developed to address the barriers and needs that women seeking long term recovery were most often experiencing. In January of 2006, with great excitement, the first 5 women entered the house as residents. Volunteers and professional staff worked together to continue outreach to the community while providing recovery support services to the residents. During 2006, the number of residents grew as the Center moved closer to their 18 person housing capacity. Unfortunately, meeting the demand for housing quickly dominated The Center s efforts and became what seemed to be an overwhelming task. Screening potential residents and providing recovery support for those women living in the Center became the focus for both the staff and volunteers. As this occurred, the number of women living in the community and participating in the WCRC declined. In March of 2007, the staff began an evaluation process to review the experience to date of the Center. Peer 3

4 volunteers, the staff, and the women who had participated, whether as members of the community or as residents, were involved in this evaluation process that resulted in several shifts in our approach to service delivery. In the remaining sections of this article, we will profile the women served by the Center, the core services of the Center, and the lessons we learned through this novel experiment of combining the provision of recovery housing and the delivery of non-residential recovery support services to women in the community within the same physical facility. Profile of Women Residents Over the past year and a half, 28 women, aged 19-47, have lived at the Women s Community Recovery Center (WCRC). These women presented with variable educational histories (7 without high school education, 13 with high school graduation or GED, 6 with some college work, and 2 college graduates), a history of unstable employment, and significant (25 of 28) legal involvement due to their past alcohol and other drug use. Multiple drug use was the norm among women residents, with only 5 of 28 women using just alcohol. Of the 28 residents served since January 2006, 9 were addicted to heroin and 14 to cocaine. All residents had received some level of drug and alcohol treatment prior to entering the WCRC, and some had multiple episodes of past treatment. 21 residents had prior involvement in a support group such as AA or NA before their admission to the WCRC. All residents had experienced more than one relapse, and many presenting with chronic relapse histories. 19 of the 28 residents were mothers, and another was pregnant at the time of her exit from the WCRC. These 19 mothers had a total of 47 children and 15 of the 19 had current or past custody problems or other serious parenting issues that had brought many to the attention of Children & Youth Services. 24 of the 28 residents came from a family where at least one (usually more) relative had a problem with alcohol or other drugs. In addition to the family of origin addiction histories, most residents were actively involved or had been involved in the past with a significant other who had a history of alcohol or other drug dependency. 22 of the residents reported physical health problems/diagnoses prior to admission. These problems ranged from Hepatitis C (10 out of 28 residents) to such problems as hypothyroid conditions, Hodgkin s Lymphoma (in remission), diabetes, arthritis, emphysema, asthma, hypertension/high blood pressure, anemia, herniated/degenerative discs, scoliosis, knee problems, kidney stones, dental issues, back pain, and migraines. 21 of the women had at least one psychiatric diagnosis, and 11 had more than one diagnosis at the time of their admission to the WCRC. The most prevalent diagnoses were depression, bipolar disorder, and anxiety disorders. Most of the residents reported prior psychiatric treatment, and most were taking medication for their psychiatric diagnoses during residency. They were often on more than one medication, with several of the residents taking psychiatric medications while being simultaneously enrolled in methadone maintenance therapy. Several residents had experienced one or more inpatient stays at mental health treatment facilities. At the most extreme, one resident had been hospitalized for mental health concerns a total of 8 times with half of those admissions prompted by a suicide attempt. Other residents were/are under the care of a psychiatrist to manage their mental 4

5 health symptoms, with most receiving psychiatric care through a local outpatient facility or through the psychiatrist at their drug and alcohol treatment program. The majority of residents (22 out of 28) had a history of trauma prior to coming to the WCRC, with reported trauma ranging from childhood or adult physical, sexual, or emotional abuse; rape; witnessing violence; death of a child; and extreme neglect. Not only had many residents experienced sexual, physical, and/or emotional abuse or neglect as a child, but many also experienced various types of violence within their adult relationships, including physical and emotional abuse by partners as well as rape and sexual assault by partners and/or strangers. It can be seen from this brief profile that the women admitted to residential recovery support presented histories of great severity, complexity, and chronicity, and in spite of their recent treatment histories, great acuity. The implication of this profile to the WCRC s self-assessment of its own capabilities will be discussed shortly. WCRC Services The women staying at the WCRC are expected to pay rent, but due to their poor financial status and difficulties in obtaining employment, many of the past residents left the WCRC owing rent money. Past residents have collectively paid $17,050 of a total of $23,000 due for rent, occurring during lengths of stay ranging from less than 2 weeks up to 40 weeks. The Center is staffed by 7 paid positions: a Women s Services Manager, a Volunteer Coordinator, a Case Manager, and four part time life skills support staff. All are recovery informed. 1 The Center currently has more than 20 volunteers. A case manager is made available to the residents in order to help them deal with the many problems residents experience navigating the traditional treatment system and in order to help identify and connect the residents with other community resources. Case managers and peer volunteer recovery coaches work with the residents to develop and implement recovery plans. Service activities in general include case management, recovery coaching, social support, education and skill building groups, and employment support. Center programming has expanded to include a monthly calendar, which is published and open to any woman in the community. Programming includes a lecture series, Life Skills workshops, Parenting, Craft/Cooking night, Bible Study, and presentations/discussions facilitated by volunteers on health and appearance. Nearly all residents are enrolled in outside professionally-directed addiction treatment while living at the Center. These treatment services are provided by local provider organizations. While living at the WCRC, all residents are strongly encouraged to attend recovery support group meetings such as AA, NA, or Women for Sobriety. WCRC residents run their own AA meeting that is open to the community every Monday afternoon and evening at the Center, and they host a Wednesday morning AA meeting that provides babysitting services. The degree of connection between WCRC residents and the local recovery community and local support groups has varied from very strong to those who have never been engaged with the local recovery community. 1 By recovery informed we mean that they have a deep knowledge of the recovery process and the recovery community either through personal or family recovery experience or through other extensive contact with people in recovery. 5

6 One of the biggest challenges Center staff and volunteers have faced is how to provide true recovery support services instead of treatment services. Working with residents who present such a wide range and intensity of problems while living at the Center has a tendency to shift staff and volunteers out of their recovery support role toward a counseling role, which is unintended and inappropriate. The pull towards this clinical role is particularly strong in the face of relapse. Half of the residents (14 out of 28) experienced a relapse while in residency. Such relapse events often led to the exit of the client shortly thereafter, whether to a higher level of care, or the client leaving against staff advice. Where many residential treatment programs and recovery houses will administratively discharge clients who have relapsed, the WCRC staff and volunteers are willing to work with the client who relapses. While residency at the WCRC is not considered a level of treatment, the idea of working with a client who has relapsed and allowing her to remain in residence is a revolutionary one. For residents who relapsed, staff and recovery coaches together examined the situation to determine the best course of action, whether that meant facilitating a referral to a higher level of care for the client, or in helping the client develop a more effective relapse prevention plan. However, residents did not always respond positively to these staff efforts In its two years of operation, the WCRC was able to establish a residential recovery support center, recruit and train a core cadre of volunteers, develop a set of core services, establish a sound referral base, and engender strong local community support. Perhaps even more importantly, 22 out of 28 women obtained employment, 12 out of 19 mothers in residence began visitation with their children, all residents were linked to the local recovery community, 8 have remained involved with WCRC services after they left residence, and 3 are active volunteers working with other women seeking recovery. The following three case studies further illustrate the characteristics of WCRC clients and WCRC recovery support services. (Names have been changed.) Marie is a 36 year old Caucasian female, single with one child with special needs. She has one older sibling, her parents are divorced, and her mother has remarried. She was referred through a local counseling center for residence. She presents as homeless, and is on prescribed Methadone as well as anti-depressant and sleeping medications. Marie is engaged in ongoing addiction and psychiatric treatment. During residence, she attended the 12 week life skills program, attended 12 Step meetings, and engaged with a Recovery Coach and a 12 Step Sponsor. Marie was able to regain joint custody of her son, and successfully complete all of her Probation and Parole requirements. She also became gainfully employed and took herself off of Medical Assistance. She displayed patterns of taking on roles of responsibility, becoming overwhelmed, then sabotaging herself. She opted to take a career position and relocate to her parents home despite staff and recovery coach feedback about this choice. She subsequently relapsed, but was able to return to treatment quickly and re-stabilize. She is currently working part time, and is actively involved in WCRC Services, Life Skills, and volunteer activity at the WCRC, while she and her son are living with her parents. Faye is a 28 year old Caucasian female, single with no children. She is the youngest of 5 children, and her parents remain married. She was referred through 6

7 a local counseling center for residence. She presented as homeless with a past history of treatment for ADHD, but was not taking prescribed medications. She was actively engaged in addiction treatment and mental health services at the time of her entry into the WCRC. During residence, she attended programming activities, the 12 week life skills program, and 12 Step Meetings, and she also engaged with a Recovery Coach and a 12 Step Sponsor. She entered the WCRC with private insurance and was unemployed. Faye achieved employment in retail, despite a college degree. She maintained the same job throughout her stay of 18 weeks. She completed the program successfully and moved on to rent a room from a woman in the Recovering Community. Faye continues to be involved in ongoing activities at the WCRC. She currently works in sales and was able to pass a State credentialing test with support from her recovery coach. She manages her ADHD through biofeedback rather than medication. She has maintained abstinence since her discharge. Hope is a 26 year old Caucasian female, single with 2 children. She is the youngest of three children, her parents are divorced, and her father has remarried. She was referred through the prison (Bucks County Correctional Facility) for residence. Hope presented as homeless and with a history of Bipolar Disorder treated with a prescribed mood stabilizer. She became actively involved in addiction treatment and mental health services through a local counseling center. During residence, she attended all of the WCRC s service programs and became actively involved in a 12 Step Program. Hope achieved employment during residence. Through the WCRC, she became involved with Bucks County Opportunity Council s self sufficiency program to seek financial assistance. She rented an apartment in the area, and continues to be employed. She recently received scholarships through the Bucks County Office of Opportunity as well as the Bucks County Chamber of Commerce for Beauty School, which she began in June She has maintained abstinence and continues to be actively involved in ongoing activities at the WCRC. The following are case histories of women living in the community who have accessed and received services through the Center s Community component (names have been changed): Elizabeth is a 40 year old woman recently arrested for her second DUI. Her longest period of abstinence was 7 years. Her last DUI was 9 years ago. She is a married mother of two teenagers, and a victim of rape and sexual abuse. Elizabeth first came to the Center as a result of her DUI. She has not had positive experiences with AA. She was matched with a Recovery Coach and attended the Life Skills Series as well as the Reading Group at the Center. She began to volunteer and attend AA. She got a sponsor, but relapsed on pain medication, and was a victim of violence during her relapse. She was admitted to a 14 day inpatient rehab. Within one week, she was transitioned into outpatient treatment. She met with her Recovery Coach weekly, who provided support with advocacy, support in helping connect with resources, and coaching with day to day problems 7

8 with family and work. Elizabeth currently has nine months of recovery and growth. As she states, The Center is a place where I am comfortable talking about things I don t talk about anywhere else-i really look forward to meeting with my Coach. We laugh and cry together. If it hadn t been for the folks at the Center, I don t know if I could have survived the relapse. Cara is a 49 year woman facing severe liver failure. Cara connected with the Center through a local hospital. Initial involvement included home visits from the staff and volunteers from the Center. Cara had been in inpatient treatment four times over the past 10 years. She was a recently divorced mother of 2 adult children. She was matched with a Recovery Coach who helped Cara develop a recovery plan, and she attended lectures at the Center as well. However, she stated that she did not feel a part of the Center because she did not live there. Cara relapsed and died of liver failure. Her death raised a lot of questions and provided an opportunity to look at how the Center could better respond to those living within the community. Lisa is a 52 year old woman with 3 adult children. She works as a waitress, and connected with a Recovery Coach. They developed a recovery plan which included ongoing meetings with her recovery coach. She received outpatient counseling and attended AA meetings as well as the Life Skills sessions at the Center. Her participation has become greater at the Center, as she has increased the number of activities she attends. In addition, she volunteers one day per week at the Center. Lessons Learned The WCRC was founded on the belief that gender-specific recovery support services could be combined with professionally-directed treatment services to enhance long term recovery outcomes. After two years, we still believe in the importance of such services, but we have learned many lessons about the challenges of implementing and sustaining such services. In reviewing our experiences of the past 24 months, the following are among the most important of such lessons. The Planning Process: It is important to note that, initially, as staff and volunteers moved through the developmental stages of the WCRC, they utilized a community development and empowerment model. The key word was inclusion: inclusion of the community via volunteers and inclusion of service recipients in the refinement of services over time. The WCRC relied extensively on volunteers from the community to form the work groups that develop rules and structure for the residents, as well as to develop the life skill building workshop curriculum. Volunteers also met to develop committees for fundraising and décor/ Center maintenance. As the Center evolved, staff took on more of a leadership role, and needs of the residents overshadowed the community outreach engagement efforts.. Part of what is important in considering future staffing for the Center is the fact that the focus is shifting more toward a community developmental model. We see knowledge of addiction and recovery as important for staff but not necessarily a background of clinical treatment experience. 8

9 Staff/Volunteer Recruitment, Training and Supervision: Effective recovery support services rest on the principle of continuity of contact in primary recovery support relationships over time. Achieving that continuity requires retention of staff and volunteers, which in turn requires a high level of technical and emotional support for their efforts. That support is best demonstrated by rigorous screening and selection, structuring orientation and on-going training programs, ready availability for consultations on difficult situations, and regular opportunities for staff and volunteer recognition. Volunteer Risk Management: Actions that volunteers take or fail to take can jeopardize the future of the best recovery support programs. This risk can be minimized by performing background checks on all applicants to serve as volunteers 2, training volunteers in ethical decision-making, providing ethical guidelines for peer-based recovery support services, and through close supervision. Role Clarity: The scope and severity of the problems experienced by women entering the WCRC challenged us to remain in our non-clinical recovery support roles. This required constant reminders to staff and volunteers that we were NOT counselors or therapists and that our job was not to fix problems but to facilitate recovery initiation and maintenance. This required significant attention in training and supervision. Gender-specific Barriers to Recovery: The lack of family support, the multiple role demands, the lack of financial resources, the past criminal records, and their own identities as outsiders severely limited the choices and access to community services of the women served by the WCRC. The histories of trauma and the resulting patterns of emotional volatility and relationship instability further compromised the ability of these women to achieve stable recovery. This is not to say that recovery is impossible, but that it requires a more complex and enduring support process than we had anticipated. Diversity: We have found that one of the most important dimensions in the delivery of recovery support services is a broad representation of pathways and styles of recovery among staff and volunteers. Ideally, people being served should be brought into contact with the full scope of such styles, including the 12 step community, faith-based recovery ministries, secular programs of recovery and those in medication-assisted recovery. That diversity should also be reflected in the age and ethnic composition of staff and volunteers. Medication Management: We had not anticipated the number of women we would serve who would be on prescribed psychotropic medication. That discovery demanded our attention via assuring continuity of medication access (e.g., women medicated in jail but given no medication upon their release to enter the WCRC), procuring a safe to secure medications, establishing a medication log to track medication consumption, staff education on medications and side effects, and increased communication with prescribing physicians. Facility Security: There were more security issues than we had anticipated, e.g., women trying to sneak out to visit boyfriends. Given the crucial importance of physical 2 A criminal background check is not intended to automatically disqualify people who have such a background (many people in long-term recovery with notable community service have such a background); the background checks are intended to screen out individuals who have an established pattern of predatory behavior who may be looking for new venues though which they can exploit vulnerable individuals. 9

10 and psychological safety in the delivery of women s services, we were forced to heighten security via a curfew, the use of security cameras, and a key fob system. Relapse Management: We were unprepared for the level of problem severity (and the accompanying in-residence relapse rate) of those we served. While we supported the philosophical position that our response to women who relapsed should be one of early re-intervention and support, this was hard to operationalize. Training of staff and volunteers about the chronic nature of severe drug dependence and the principles of longterm recovery management helped us sort through the best options in the face of such relapse incidents. Use of Community Resources: The key to effective recovery support centers is aligning the power of local community resources in support of recovery initiation and recovery maintenance. It was very important for us to establish constant and consistent communication with outside agencies to help our residents access the services that they needed, as well as to help keep us up to date on changes in our participants status with other community agencies. Co-location of Services: The central question the WCRC has faced is this: Can a recovery home and a recovery support center co-exist within the same physical facility? Responding to the overwhelming needs of the WCRC residents and the limits imposed by the physical design of the WCRC facility have prevented significant community participation. After careful deliberation, the WCRC has devised several changes to improve our ability to serve women living in the community. We suspect if we remained on the current path that co-location would have resulted in doing one or the other function well but that it would be very hard to maintain a level of excellence in service to both women in residence and women in the community. The Evolution of the Center In January of 2007, Dr. Stacey Conway collected and analyzed data on the Center and its residents. A Study Committee was developed to review the results and make recommendations to ensure the Recovery Support needs of the community were being met. The major finding was that housing 18 women within the Center would not allow for the community component of the program to grow and meet the needs of community members. As a result of that finding, the Committee recommended that the WCRC: Change the name of the Center from Women s Community Recovery Center (WCRC) to Women s Recovery Community Center (WRCC) to better reflect the mission and purpose of the facility. Reduce the number of women living in the Center to six. Make renovations to make the house property more appealing to members of the community. Adjust screening protocols for potential residential candidates to ensure that the level of services we offer meets the level of services they need. Develop a Vision Committee to steer the ongoing programming provided through the center. Everyone entering the center is personally welcomed and oriented to Center services and Activities. An outreach and marketing plan needs to be developed and implemented. 10

11 Additional, sustainable funding sources need to be identified. Have Information Specialists on site to provide information, advocacy, referral, and recovery support to anyone participating in Center. As we think about the future of the Center, we want to re-engage and re-energize the Volunteers and then establish a diverse, 10-member Vision Committee, facilitated by Dr. Stacey Conway, to steer the direction of the future programs, projects, and services available through the Community Center. Our goal is to continuously improve the availability of the Center to provide access to women from the community who want to access, strengthen, and sustain long term recovery. We are continuously adjusting this pioneering model. Summary Calls to transform addiction treatment into recovery oriented systems of care are triggering new experiments in the delivery of pre-treatment, in-treatment and posttreatment recovery support services. Two such experiments involve the proliferation of self- or staff-managed recovery homes and the rise of recovery support centers. This paper describes the attempt of the Pennsylvania Recovery Organization-Achieving Community Together (PRO-ACT) to operate a gender-specific recovery home and a recovery support center within the same facility in New Britain, Pennsylvania. In its first two years of operation, the Women s Community Recovery Center (WCRC) served 28 women in residence while attempting to also offer recovery support services to women in the larger community. The needs of the women being served in residence were so great and so complex that responding to these needs consumed the majority of staff and volunteer resources. Some of the critical lessons learned from this experience include the importance of community and consumer involvement in the planning and implementation process, the necessity for boundary management between clinically-oriented treatment services and non-clinical recovery support services, the importance of volunteer training and support, and the value of assertively linking the women being served to local communities of recovery and other formal and informal resources in the community. References Grella, C.E., & Greenwell, L. (2004). Substance abuse treatment for women: Changes in the settings where women received treatment and types of services provided, The Journal of Behavioral Health Services & Research, 31(4), Kandall, S. (1996). Substance and shadow: Women and addiction in the United States. Cambridge, MA: Harvard University Press. Kaskutas, L. (1994). What do women want out of self-help? Their reasons for attending Women for Sobriety and Alcoholics Anonymous. Journal of Substance Abuse Treatment, 11(3), 186. LaFave, L.M. (1999). An argument for choice: An alternative women s treatment program. Journal of Substance Abuse Treatment, 16(4),

12 McCarthy, P. (2006). Personal Communication, Patty McCarthy, Executive Director, Friends of Recovery Vermont. Schliebner, C. (1994). Gender-sensitive therapy: An alternative for women in substance abuse treatment. Journal of Substance Abuse Treatment, 11(6), Uziel-Miller, N., & Lyons, J.S. (2000). Specialized substance abuse treatment for women and their children: An analysis of program design. Journal of Substance Abuse Treatment, 19, Valentine, P. (2006). Personal communication Phil Valentine, Director, Connecticut Community of Addiction Recovery. Valentine, P., White, W., & Taylor, P. (2007) The recovery community organization: Toward a definition. Posted at Walitzer, K.S., & Dearing, R.L. (2006). Gender differences in alcohol and substance use relapse. Clinical Psychology Review, 26, Wechsberg, W.M., Craddock, S.G., & Hubbard, R.L. (1998). How are women who enter substance abuse treatment different than men?: A gender comparison from the Drug Abuse Treatment Outcome Study (DATOS). In S.J. Stevens, & H.K. Wexler (Eds.), Women and substance abuse: Gender transparency (pp ); and Drugs & Society, 13(2), White, W. (1996). Slaying the dragon: The history of addiction treatment and recovery in America. Bloomington, IL: Chestnut Health Systems. White, W. (2004). Women who made (and are making) a difference. Counselor, 5(5), White, W.L. (in press). A recovery revolution in Philadelphia. Counselor. White, W. & Kurtz, E. (2006). Linking Addiction Treatment and Communities of Recovery: A Primer for Addiction Counselors and Recovery Coaches. Pittsburgh, PA: Institute for Research, Education and Training in Addictions. White, W., & Sanders, M. (2004). Recovery management and people of color: Redesigning addiction treatment for historically disempowered communities. In White, W., Kurtz, E. & Sanders, M. Recovery Management. Chicago, IL: Great Lakes Addiction Technology Transfer Center. Acknowledgment: Stacey Conway, Ph.D., Julia Babij, M.S.and Maura Farrell assisted in the development of this article. Support for development of this article was provided by the Philadelphia Department of Behavioral Health and Mental Retardation Services. About the Authors: Beverly Haberle is Executive Director of the Bucks County Council on Alcoholism and Drug Dependence, Doylestown, PA.and Project Director for PRO-ACT. William White is a Senior Research Consultant at Chestnut Health Systems and a consultant for the Philadelphia Department of Behavioral Health and Mental Retardation Services. 12

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